2016 British Medical Association BMA Guide To Effective Communication 2016

A guide to effective communication:

inclusive language in the workplace

British Medical Association

bma.org.uk

British Medical Association

A guide to effective communication: inclusive language in the workplace

Why is language important?

We are committed to promoting equal rights and opportunities, supporting diversity, and
creating an open and inclusive environment for our members, employees and stakeholders.
The successful implementation of equality and inclusion in all aspects of our work will
ensure that members, colleagues and staff are valued, motivated and treated fairly. It will
allow us to respond appropriately and sensitively to an increasingly diverse society.

As an association, an important way that we can affirm our commitment to equality and
inclusion is through the use of inclusive language. This guide promotes good practice
through the use of language that shows respect for, and sensitivity towards everyone. The
choice of appropriate words makes an important contribution towards the celebration of
diversity. As well as avoiding offence, it is about treating each other with dignity and as equal
members of an integrated community. Language is dynamic, and terms disappear, re-
emerge and are revised. We all need to be sensitive to changing expressions and meanings
as they emerge.

This guidance should be applied to all forms of communication, including conversations,
committee papers, documents, letters, emails and the website. Anything that we
produce reflects the association and it is vital that all our communications are free from
discriminatory language, or what could be interpreted as discriminatory language. Using our
values and behaviours as the foundation, inclusive language does not discriminate against
anyone on the basis of any of the protected characteristics in the Equality Act 2010.

What is The Equality Act 2010?1

The Equality Act 2010 brought together existing equalities legislation (eg Disability
Discrimination Acts, Race Relations Acts, and Equal Pay Act). It covers the same groups
that were protected by existing equality legislation but extends protections to groups
not previously covered, and strengthens particular aspects of equality law. The nine
'protected characteristics' in the Act are:

- age

- disability

- gender

- gender reassignment

- race (this includes ethnic or national origins, colour and nationality)

- religion or belief

- sexual orientation

- marriage and civil partnership

- pregnancy and maternity

What is discriminatory language?

Discriminatory language includes words and phrases that:

- reinforce stereotypes

- reinforce derogatory labels

- exclude certain groups of people through assumptions, eg assuming the male or
white population is the norm

- patronise or trivialise certain people or groups, or their experiences

- cause discomfort or offence

1 You can read moreaboutthe Equality Act 2010 here: www.gov.uk/guidance/equalitv-act-2010-guidance

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Some things to remember when considering...

Age

Age discrimination can be a serious barrierto younger and older people playing an equal
part in society. Inclusive language should be sensitive to the entire age range, which is
particularly important given the UK’s ageing population. It is good practice to avoid terms
that may be perceived as a manifestation of ageism. Ageism is found in negative, derogatory
or abusive language, which can be targeted towards people of any age - young and old.

You should avoid using language that stereotypes or implies that a particular age group is
more or less able. If you are using terms such as ‘older’ and ‘younger’ remember that these
are relative and should be used within a clear and specific context.

Disability

It is important to remember that the word 'disabled’ is a description, and does not refer to
a group of people. You should always avoid any unnecessary reference to disability, and
avoid using insensitive and patronising descriptions or language. Do not use terminology
that emphasises the disability rather than the person, or which equates the person with
the ability or disability. You should also avoid using terminology and medical labels that
reinforce stereotypes of victimhood or suffering as part of any illness, disease, disability
or impairment.

Only refer to a person’s disability or any specific requirements they may have where these
are relevant. Where needed, phrase references by stating the person first and reference to
the disability second, eg ‘a child with autism’ rather than an ‘autistic child’. Make sure that
you are using precise and accepted terms (where possible, ask the individual).

Gender

The English language appears to have evolved on the assumption that the world is male.

We refer to 'the man in the street’, or 'manning the phones’, and talk about the ‘taxman’,
'layman’s terms', ‘as every schoolboy knows’ and so on.

Gender neutral language avoids stereotyping people according to their sex. Although
stereotyping can affect men adversely, women are more often affected because former
convention was to assume that an individual of unknown gender was male, or to use male
gendered language to cover both sexes. For example, the words ‘policeman’ and ‘stewardess’
are gender-specific; the corresponding gender-neutral terms are ‘police officer’ and ‘flight
attendant’. Other gender-specific terms, such as ‘actor’ and ‘actress’, may be replaced by the
originally male term; for example, ‘actor’ used regardless of gender.

You should avoid references to a person's gender except where it is relevant in a discussion.

If you don’t know for certain what gender to use when talking about a person’s loved ones, or
if you aren't sure whether someone identifies as male or female, keep your language neutral
until you know what terms they prefer to use. For example, use the word ‘partner’ instead of
‘wife’ or ‘husband’, ‘parent’ instead of ‘Mum’ or ‘Dad’, and ‘child’ instead of ‘son’ or ‘daughter’.
You can also mix up the word order in common expressions, eg instead of saying, ‘men and
women’, use ‘women and men’.

If you do not know the marital status of a woman you should use ‘Ms’ instead of ‘Miss’. You
should also respect a woman’s preference to be referred to using the title ‘Ms’. A new gender-
neutral title ‘Mx’ is now being widely used by the Government and many businesses in the UK
and should be included as a title option in any application or monitoring forms.

An example of BM A good practice

It is best practice to use language that avoids gender discrimination, for example,
avoiding the term ‘chairman’. We should all use the terms ‘chair’, ‘co-chairs’ and
deputy chair’.

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Gender reassignment

Under the Equality Act 2010, a person has the protected characteristic of gender
reassignment if they are proposing to undergo, are undergoing, or have undergone
a process (or part of a process) for the purpose of reassigning their sex by changing
physiological or other attributes of sex.

Transgender is an umbrella term used to describe people whose gender identity differs
from the sex they were assigned at birth. Gender identity is a person's internal, personal
sense of their own gender, whether male, female or non-binary (an umbrella term fora
person who does not identify as male or female). For transgender people, the sex they were
assigned at birth and their own internal gender identity do not match.

Transsexual is an adjective to describe a person who was assigned one sex at birth,
who is, or has implemented the personal process of gender reassignment through
medical interventions (including but not limited to hormones and/or surgeries). Unlike
transgender, transsexual is not an umbrella term. Many transgender people do not
identify as transsexual and prefer the word transgender. Transgender may be preferred
by some individuals mostly because it moves away from the sensitive sexual word and
focuses more appropriately on the chosen and expressed identity of that individual.

Trans-inclusive language is language that acknowledges that some people identify as
a gender other than the one they were assigned at birth. It is best to ask which term
an individual prefers. If transsexual is preferred, it is betterto use as an adjective, eg
transsexual woman or transsexual man.

For more information look at the Stonewall glossary of terms.

Marriage and civil partnership

In the UK same sex couples have been able to form a legally recognised relationship,
known as a civil partnership, since 2005. Couples who form a civil partnership have a new
legal status - that of a 'civil partner', where the couple gains rights and responsibilities
similarto that of a marriage. A civil partnership ends only on a formal dissolution or
annulment, or on the death of one of the parties. The Marriage (Same Sex Couples) Act
2013 extends marriage to same sex couples, and couples can have a civil marriage in
registry offices across England and Wales. In March 2014 legislation to allow same sex
marriages was passed.

When asking about marital status, it is better to ask about a person's relationship status,
or about their marital/civil partnership status. It’s important that relationship status
includes the options of being:

- single

- married/civil partner

- divorced/dissolved civil partnership

- widow/widower/surviving civil partner

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Pregnancy and maternity

Gender inequality is reflected in traditional ideas about the roles of women and men.
Though they have shifted over time, the assumptions and stereotypes that underpin
those ideas are often deeply rooted.

It is common to assume a woman will have children, look after them and take a break
from paid work or work part-time to accommodate the family. If a woman is forgetful
during pregnancy, this is often referred to as her 'baby brain’. However, such assumptions
and stereotypes can and often do have the effect of seriously disadvantaging women.

A large majority of people that have been pregnant or have given birth identify as women.
We can include intersex men and transmen who may get pregnant by saying 'pregnant
people’ instead of 'expectant mothers’.2

2 Intersex is a term used to describe a person who may have the biological attributes of both sexes or whose
biological attributes do notfit with societal assumptions about what constitutes male orfemale. Intersex people
can identify as male, female or non-binary.

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Race (including ethnic or national origins, colour and nationality)

The UK is a racially and culturally diverse place. Using inclusive language is about valuing
others and building bridges with people from any background. Our values guide us to adapt
according to audience and context, adding a touch of warmth where appropriate. Race is an
area where language changes particularly quickly and what is acceptable to some may not
be to others. No individual is just one single thing and, therefore, no one can be summarised
with a single word. Cultures and identities are continually changing, not least because of
the interactions they have with each other. It is best to be guided by the terms people use to
describe themselves.

You should only use a person’s race to identify, or describe, them if it is directly relevant to
the point you are making. It’s important not to assume that a person’s appearance defines
their nationality or cultural background. Avoid stereotyping and making positive or negative
generalisations about members of a particular race, ethnic, cultural or national group.

In the UK, BME (black and minority ethnic) or BAME (black, Asian and minority ethnic) is the
terminology that is normally used to describe people of non-white descent. Terms such as
Black British, British Muslim, South Asian British and so on are often appropriate. Difficulties
can arise with expressions that use 'black’ in a negative way, eg 'black sheep', or 'black mark’.

Where appropriate, it is good practice to make documents available in other languages, eg if
a large proportion of an intended audience are not native English speakers.

Religion or belief

Not everyone defines their identity in terms of a religion but all human beings have beliefs
and values. The accurate use of language in these aspects of human experience is to
demonstrate respect for the beliefs of others. It is a simple but important mark of respect for
others if we use language that is appropriate to them. For example, to ask a Jewish or Muslim
person their Christian name not only makes no sense, but is also highly disrespectful of their
beliefs. The use of the terms 'forename' or 'first name’ prevents any misunderstanding and
acknowledges that people have different beliefs.

You should not make assumptions about individuals based on their professed religion or
belief system. Not all members of a religion follow the same practices and observances.
Some of the most commonly practiced religions and beliefs in Britain are (2011 census):

- Christianity

- Islam

- Hinduism

- Sikhism

- Judaism

- Buddhism

- No religion

Further guidance on religions and the requirements of the Equality Act 2010 is provided in
the ACAS guide Religion and belief in the workplace — some key areas. Further information
can be found in the BBC Guide to Religion: www.bbc.co.uk/religion/religions.

An example of BMA good practice

Religion and belief: best practice resource for arranging meetings
An important way in which we affirm our commitment to equality and inclusion is
by considering the implications of religion and belief as factors that may prevent
participation in meetings, eg religious holidays. The best practice resource Religion and
Belief: best practice resource for arranging meetings provides practical information on
things to be considered in order to show respect for, and sensitivity towards everyone.

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Sexual orientation

Sexual orientation describes an individual’s enduring physical, romantic and/or emotional
attraction to another person. Language is often used in a way that ignores the fact that a
significant proportion of the population is not heterosexual. We need to be aware that all
outputs, written or verbal, may be read and heard by people of differing sexual orientations.
Therefore, language that we use must be inclusive and should not cause offence.

Be careful not to make assumptions about people’s personal circumstances. For example,
do not use terminology that assumes that everyone has a partner of the opposite sex.
Always try to use the term that is preferred by the individual. The following terms are
associated with sexual orientation:

Bisexual

A person who has an emotional, romantic and/or sexual orientation towards more than
one gender.

Gay

A man who has an emotional, romantic and/or sexual orientation towards men. The preferred
term to describe homosexual men. Also a generic term for lesbian and gay sexuality- some
women define themselves as gay rather than lesbian.

Heterosexual/straight

A person who has an emotional, romantic and/or sexual orientation towards people of the
opposite sex.

Homosexual

This might be considered a more medical term used to describe someone who has an emotional,
romantic and/or sexual orientation towards someone of the same gender. The term 'gay' is now
more generally used.

Lesbian

A woman who has an emotional, romantic and/or sexual orientation towards women. Some
lesbian women prefer to be referred to as gay women.

For more information and resources visit the Stonewall website.

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Quick reference guide

Age

Helpful hints

Instead of...

Use...

When defining age ranges do
not exclude older age groups.
Age cut-off points are one of
the major ways in which the
older population
are excluded.

Under 1,1-9, 10-19,
20-34,35-54,55-65

Under 16, 16-19, 20-24,
25-29,

30-34, 35-39, 40-44, 45-49,
50-54, 55-59, 60-64, 65-69,
70-74, 75+

Use the preferred term and be
aware that language changes
and evolves.

The elderly

Aged

Old people

Senior citizen

Pensioner

Older person

Older people

Older citizens

Older adult

When writing job descriptions
and job/committee seat
advertisements, focus on
the skills and aptitudes
required for the post rather
than number of years of
experience,
or age.

[XX] many years’
experience

Mature

Young

Use words relating to the

desired attributes of an

applicant:

proven experience

adaptable

enthusiastic person

reliable

good communication skills
etc.

When interviewing
candidates, try to avoid asking
questions related to age,
instead concentrate on the
applicants’ competencies.

How would you feel about
managing older/younger
people?

What skills do you have to
enable you to effectively
manage a team?

HR has a bank of competency-
based questions that also link
to our values and behaviours.

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Disability

Helpful hints

Instead of...

Use...

Avoid blanket expressions
that refer only to the
impairment. Make it clear
that you are talking about a
person. People should not be
identified or defined in terms
of any impairment that they
may have. The general rule is
put people first.

Use adjectives, rather than
nouns, where it is
important to identify
someone’s impairment.

The disabled

The blind

Wheelchair-bound

An asthmatic

Disabled people

People with visual
impairments, people who are
partially sighted

Wheelchair user

An asthmatic person

Use the correct term for the
impairment. Avoid terms that
are now considered offensive.

If it is necessary to refer to
a person’s impairment or
condition, check with the
individual how they wish it to
be described.

Spastic

Mongol

Mentally handicapped

Person with cerebral palsy
Person with Down’s syndrome
Person with learning
difficulties

Talk about barriers and

solutions.

Avoid implying that people
with impairments are less
fortunate, are ’suffering’,
present a ’problem’, or require
any special treatment.

Special arrangements
have been made to

accommodate deaf
people

Please let the organisers
know if you cannot use
stairs

Please let us know if you
require any assistance
to enable you to attend/
participate. If you would
like to discuss your access
requirements further, please
contact...

The facilities are equipped
with loop hearing systems

When talkingaboutthe
facilities that we have use the

term ’accessible’.

Disabled parking space
Disabled toilets

Disabled lifts etc

Accessible parking spaces
Accessible toilets

Accessible lifts etc

Avoid any implication that a
physical impairment implies a
learning difficulty.

Posing questions to
others, eg would they like
some coffee? Does he
take sugar?

Speak to the individual
themselves,
eg would you like some
coffee?

Someone with learning
difficulties does not
necessarily have low or high
intelligence, or any innate
inability to learn. It specifically
means that they have an
impairment that is less suited
to normal teaching methods.

Speaking slowly and
assuming low intelligence

Speak in your normal manner
and tone

When interviewing
candidates, try to avoid asking
questions related to age,
instead concentrate on the
applicants’ competencies.

How would you feel about
managing older/younger
people?

What skills do you have to
enable you to effectively
manage a team?

HR has a bank of competency-
based questions that also link
to our values and behaviours.

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Gender

Helpful hints

Instead of...

Use... |

Where you do not know and

Dear Mr [NAME]

Dear Ms/Mr [NAME] if you

cannot find out the correct

Dear Sir

know the family name

gender of

a correspondent.

Dear Sir/Madam if you don’t

know the family name

Where you know the first

Dear Ms/Mr [NAME]

Dear [FIRST NAME] [FAMILY

name

NAME],

and surname, but not the

eg Dear Chris Jones

gender

of the correspondent.

On forms, ask individuals to

Prof

Dr

select from a comprehensive

Dr

Miss

alphabetical list of titles, and/

Mr

Mr

or leave the field blank for

Mrs

Mrs

them to complete. Ideally,

Miss

Ms

do not put the list into a

Ms

Mx

perceived hierarchy.

Mx

Prof

etc

etc

Avoid using he, his, him etc to

The lecturerwill display

Lecturers will display their

apply to both sexes. Use he.

his timetable on his office

timetables on their office

his, him, himself only when

door

doors

referring specifically to a male

person. Instead of referring to

Each student is

Students are responsible for

both sexes with words such

responsible for material

material they borrow

as he, him, his, use terms that

on loan to him

cover both, eg 's/he’, ‘she or

he’, ’they’.

Avoid using his or her after

Anyone who wants his

Anyone who wants their work

’each’, ’someone’, ’anyone’.

work evaluated

evaluated

’nobody’.

Avoid using man to mean

Man or mankind

Plumanity, humans, human

people in general. It is not

Man-hours

beings, people, or society

good practice to present

Manpower

Work hours or staff time

material with the disclaimer

that all masculine nouns and

Staff, workforce, personnel.

pronouns are to be taken as

workers

referring to both females and

male.

Avoid using terms that may

Girls

The person’s name, their

give offence to women or

Ladies

professional title or ’men’ and

men.

Dear

’women’

Son

Love

Avoid irrelevant, gratuitous

A female doctor

A doctor

gender descriptions.

A male nurse

A nurse

Avoid using Miss/Mrs unless

Miss/Mrs

Ms-Thisterm is intended

the individual concerned

to parallel Mr as it does not

expressly indicates that they

identify marital status

wish otherwise.

Avoid titles that imply that

Chairman

Chair, chairperson

the normal job-holder is of a

Policeman

Police officer

particular gender.

Cleaning ladies

Cleaners

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Gender reassignment

Helpful hints

Instead of...

Use...

Use the term trans/
transsexual/transgender
as an adjective rather than

a noun

A transsexual

Transsexual/transgender
person or trans person

When you must use a gender
specific pronoun, use the
term preferred by the
individual.

If it is not possible to ask a
transgender person which
pronoun is preferred, use the
pronoun that is consistent
with the person’s appearance
and gender expression.

She or her (for a trans-
male, ie female to male)

He or his (fora trans-
female, ie male to female)

He or his (for a trans-male, ie
female to male)

She or her (for a trans-female,
ie male to female)

Don’t use phases that are
reductive and overly-simplify
a complex subject. A person’s
sex is determined by a
number of factors.

Biologically male/female

Genetically male/female

Born and man/woman

Assigned male/female
at birth

Designated male/female
at birth

Be careful when describing
the personal process of
gender reassignment.

Sex change/sex change
operation

Pre-operative

Post-operative

Transition

Referring to a sex-change
operation, or using terms
such as pre-operative or
post-operative inaccurately
suggests that one must have
surgery in order to transition.

Marriage and civil partnership

Helpful hints

Instead of...

Use...

Application forms and equal

Asking someone’s marital

What is your relationship

opportunities monitoring

status or specifying

status? or

forms should be amended

marital status options:

What is your marital/civil

to include this new legal

- single

partnership status?

relationship status.

- married

- divorced

- widow/widower

Relationship status options:

- single

- married/civil partner

- divorced/dissolved
civil partnership

- widow/widower/surviving
civil partner

Pregnancy and maternity

Helpful hints

Instead of...

Use...

A large majority of people that
have been pregnant or have
given birth identify as women.
However, there are some

intersex men and trans men
who may get pregnant.

Expectant mothers

Pregnant people

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Race (including ethnic or national origins, colour and nationality)

Helpful hints

Instead of...

Use... j

Use adjectives, rather than
nouns, where it is important
to identify someone’s race.

The Asians etc...

Asian students etc...

Avoid irrelevant, gratuitous
ethnic descriptions.

A Chinese professor

A professor

It is important to always allow
people to define themselves.

Coloured people
Black/Asian when
referring to all minority
ethnic groups

The term preferred by the
individual, eg Asian, Afro-
Caribbean, Black etc

Religion or belief

Helpful hints

Instead of...

Use... |

Avoid using terms that may

Christian name

First name, given name.

offend people’s religious

Surname

forename or personal

sensibilities.

Last name

Family name (preferred term)

Surname is not unacceptable.
However, this word may
originate from sire-name,
orthe name derived from

one’s father.

The term 'last name’ should

not be used as it could be
confusing to Asian groups who
place their family name first.

Sexual orientation

Helpful hints

Instead of...

Use... |

Use the term preferred by
the individual.

The blanket term

homosexual

Gay, lesbian, bisexual, gay
man, gay woman

Use all these terms to
describe these groups/
individuals

LGB (lesbian, gay and
bisexual) is a common
acronym used for the
collective term

Use adjectives, rather than
nouns, where it is important
to identify someone’s
sexual orientation.

Lesbians, gays or
bisexuals

People who are lesbian, gay
or bisexual

Avoid assumptions about a
person’s sexual orientation
and using heterosexual-
centred language. Such
language is based on the
belief that heterosexuality is
the only normal, valid or moral
basis for partnerships.

Husband, wife and spouse
Girlfriend or boyfriend
Family planning clinic

Partner or accompanying
person (so as to not
discriminate between
married, unmarried or same
sex partners)

Partner (or term preferred by
the individual)

Sexual health clinic or sexual
health and wellbeing clinic

For further information please contact Yasemin Dil, corporate equality, diversity
and inclusion manager, strategy and insight directorate on ydiKcjbma.org.uk

BMA London

British Medical Association, BMA House,
Tavistock Square, London WC1 H 9JP
bma.org.uk

© British Medical Association, 2016

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